Neurosurgeons Leading the Way on Sports-related Head Injury

debGuest Post from Deborah L. Benzil, MD, FACS, FAANS
Member, AANS Board of Directors
Chair, AANS/CNS Communications and Public Relations Committee
MKMG
Columbia University Medical Center
Mt Kisco, New York

Sports-related head injuries are serious business:

brainThe high profile efforts of the National Football League are a start at bringing much needed attention to this problem and the need for good policies has begun to filter down to the college and high school levels. Organized neurosurgery has long championed the need for attention to this problem. Highlighted in a recent Neurosurgery Report are articles on sports concussions. We are proud of the landmark work included in this important publication.

Click here, to read crucial articles on all aspects of sports-related concussions.

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5 Things Neurosurgeons Need to Know about the Sunshine Act

Despite the problems associated with the Physician Sunshine Open Payments system, including inaccurate data and computer system problems, on Sept. 30, 2014, the Centers for Medicare & Medicaid Services (CMS) released physician-industry data on the Open Payments public website.

Now that the Open Payments data is publicly available, here are 5 things neurosurgeons need to know about Sunshine Act (image courtesy of the Partners for Healthy Dialogues).

5 Things Physicians Need to Know

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Ebola, Bats and Neurosurgery

Guest post from
Chaim B. Colen, MD
Chair of the Young Physicians Representative Section of the CSNS
Grosse Pointe Woods, MI

batDefinition

Ebola virus hemorrhagic fever disease is a severe infection. In humans, it can have a mortality rate of up to 90 percent. The infection can occur in humans and animals. In nature, fruit bats are believed to be natural carriers of the virus without adversely affecting the bat. Humans become infected through contact with infected bats or other living or dead animals that have been infected by bats. Researchers have concluded that today’s largest ever Ebola epidemic has been spread by colonies of migratory fruit bats. To further compound the problem, in west Africa, fruit bats are widely eaten by natives – either smoked, grilled or in a spicy soup; thus further facilitating transmission of the Ebola virus to humans.

As a Neurosurgeon and PhD scientist who trained at Wayne State University – the training grounds of the Ebola victim in New York, Dr. Craig Spencer – with a keen interest in the brain, finds Ebola viral transmission fascinating. Unlike most common bats, fruit bats do not echolocate (ie. emit sound and use their ears to locate echo “sonar style”). Instead, fruit bats have large eyes and complex visual centers in the brain. Fruit bats require good vision, because when they forage at night for nectar and fruit, they orient by vision and the sense of smell. During the flights to the foraging grounds at dusk and the return to the daytime roost at dawn, the animals navigate solely by vision. On moonless nights, when visibility is poor, fruit bats cannot fly and stay hungry.

Causes of Infection

A carrier bat that is infected by the Ebola virus can infect a human. The virus can pass from person to person through blood or other bodily secretions. When these fluids come in contact with skin or mucus membranes the virus can pass and cause the infection. The virus can also pass through contaminated needles. However, a cause for alarm, both here and in Africa, is how several medical personnel have died after caring for sickly patients infected with Ebola despite donning protective gear.

Risk Factors

So let’s learn about how we can avoid contracting this deadly disease.

  • Don’t travel to areas with known Ebola outbreaks -sub-Saharan Africa. For the first time, several cases have been reported in the U.S.
  • Avoid exposure to a healthcare setting that has treated a person with Ebola hemorrhagic fever.
  • Don’t have contact with another person who has Ebola hemorrhagic fever.

Symptoms

Symptoms of Ebola may be caused by other, less serious health conditions. They may include:

  • Fever
  • Headache
  • Joint and muscle aches
  • Sore throat
  • Weakness
  • Diarrhea
  • Vomiting
  • Stomach pain
  • Rash
  • Red eyes
  • Hiccups
  • Internal and external bleeding

Importantly, if you have any of these symptoms do not assume it is due to Ebola. Seek medical attention.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. If you may have been exposed to the virus and develop symptoms suggestive of viral disease, your doctor will notify health officials. This will include the local health department and the Centers for Disease Control and Prevention.

To confirm the presence of the virus your doctor may order blood tests. These tests will help identify the virus itself and antibodies to the virus. Antibodies are signs that your body has identified and is fighting the virus.

Treatment

Treatment is focused on supporting you while your body fights the infection. You will be isolated to prevent the spread of the disease. Treatment may include:

  • IV fluids and electrolytes
  • Oxygen and blood pressure support
  • Treatment for any secondary infections

Prevention

Taking steps to help reduce your chance of getting Ebola hemorrhagic fever are paramount:

  • Avoid traveling to an area that is experiencing an outbreak.
  • If you are a health care worker, wear protective clothing. This includes masks, gloves, gowns, and goggles.
  • Avoid reusing needles.
  • Avoid contact with anyone who may have been exposed to the Ebola virus.

Resources

References
1. Josh Mugele, M.D., and Chad Priest, R.N., M.S.N., J.D.
N Engl J Med 2014; 371:1185-1187September 25, 2014DOI: 10.1056/NEJMp1410301

2. Ebola hemorrhagic fever. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/ebola.htm. Accessed May 17, 2013.

3. Ebola hemorrhagic fever. World Health Organization (WHO) website. Available at: http://www.who.int/mediacentre/factsheets/fs103/en/. Updated August 2012. Accessed May 17, 2013.

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